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Tsinopoulou VR, Kotanidou EP, Athanasiadis N, Bacopoulou F, Stefanaki C, Fidani L, Galli-Tsinopoulou A, Christoforidis A. Earlier Menarche in Greek Girls Born by Caesarean Section: A Case-Control Study. J Clin Med 2024; 13:3452. [PMID: 38929980 PMCID: PMC11204395 DOI: 10.3390/jcm13123452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/04/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Objectives: The purpose of this study was to report on the menarcheal age in girls of Greek origin and assess its potential associations with their demographic and perinatal data, as well as their maternal menarcheal age. Methods: In this case-control study, adolescent girls were recruited between September 2021 and September 2022 from two Pediatric Endocrinology Units, Aristotle University of Thessaloniki, Greece. Eligible participants included Greek girls up to the age of 18 years, with menarche and the absence of chronic disease or chronic medication use. Participants were divided into two groups, the early menarche group and the control group (menarche before or after 11 years of age, respectively). Data included participants' maternal menarcheal age, their chronological age, place of residence, anthropometric data (at recruitment) and perinatal data (birth order, gestational age, type of delivery, birth weight/length). Results: A total of 100 girls aged 7-17 years (mean age ± SD 12.51 ± 2.59 years) were included in this study. The mean ± SD menarcheal age of the total sample was 11.47 ± 1.55 years (median 11.20 years; range 7.50-16.25 years); 43% had early menarche (median menarcheal age 10.50 years; range 7.50-10.91 years), and 57% had menarche after age 11 (median menarcheal age 12.08 years; range 11.00-16.25 years). The caesarean section rate was significantly (p < 0.001) higher in girls with early menarche (83.7%) than controls, whereas other variables did not differ significantly between groups. Conclusions: This Greek sample demonstrated a relatively young age at menarche with a significant proportion of girls with early menarche; in the latter group, the rate of caesarian sections was significantly higher than controls.
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Affiliation(s)
- Vasiliki Rengina Tsinopoulou
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University General Hospital AHEPA, 54636 Thessaloniki, Greece
- 1st Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 54636 Thessaloniki, Greece
| | - Eleni P. Kotanidou
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University General Hospital AHEPA, 54636 Thessaloniki, Greece
| | - Nikolaos Athanasiadis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 54636 Thessaloniki, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Charikleia Stefanaki
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Liana Fidani
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University General Hospital AHEPA, 54636 Thessaloniki, Greece
- Laboratory of Genetics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Assimina Galli-Tsinopoulou
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University General Hospital AHEPA, 54636 Thessaloniki, Greece
| | - Athanasios Christoforidis
- 1st Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 54636 Thessaloniki, Greece
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Tao MY, Liu X, Chen ZL, Yang MN, Xu YJ, He H, Fang F, Chen Q, Mao XX, Zhang J, Ouyang F, Shen XH, Li F, Luo ZC, Shen X, Huang H, Sun K, Zhang J, Wang W, Xu W, Ouyang F, Li F, Huang Y, Zhang J, Yan C, Shen L, Bao Y, Tian Y, Chen W, Zhang H, Tong C, Xu J, Zhang L, Zhang Y, Jiang F, Yu X, Yu G, Chen J, Zhang Y, Li X, Cheng H, Zhang Q, Duan T, Hua J, Peng H. Fetal overgrowth and weight trajectories during infancy and adiposity in early childhood. Pediatr Res 2024; 95:1372-1378. [PMID: 38200323 DOI: 10.1038/s41390-023-02991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/02/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood. Little is known about how infancy growth trajectories affect adiposity in early childhood in LGA. METHODS In the Shanghai Birth Cohort, we followed up 259 LGA (birth weight >90th percentile) and 1673 appropriate-for-gestational age (AGA, 10th-90th percentiles) children on body composition (by InBody 770) at age 4 years. Adiposity outcomes include body fat mass (BFM), percent body fat (PBF), body mass index (BMI), overweight/obesity, and high adiposity (PBF >85th percentile). RESULTS Three weight growth trajectories (low, mid, and high) during infancy (0-2 years) were identified in AGA and LGA subjects separately. BFM, PBF and BMI were progressively higher from low- to mid-to high-growth trajectories in both AGA and LGA children. Compared to the mid-growth trajectory, the high-growth trajectory was associated with greater increases in BFM and the odds of overweight/obesity or high adiposity in LGA than in AGA children (tests for interactions, all P < 0.05). CONCLUSIONS Weight trajectories during infancy affect adiposity in early childhood regardless of LGA or not. The study is the first to demonstrate that high-growth weight trajectory during infancy has a greater impact on adiposity in early childhood in LGA than in AGA subjects. IMPACT Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood, but little is known about how weight trajectories during infancy affect adiposity during early childhood in LGA subjects. The study is the first to demonstrate a greater impact of high-growth weight trajectory during infancy (0-2 years) on adiposity in early childhood (at age 4 years) in subjects with fetal overgrowth (LGA) than in those with normal birth size (appropriate-for-gestational age). Weight trajectory monitoring may be a valuable tool in identifying high-risk LGA children for close follow-ups and interventions to decrease the risk of obesity.
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Affiliation(s)
- Min-Yi Tao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
- Lunenfeld-Tanenbaum Research Institute, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerity Faculty of Medicine, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5G 1X5, Canada
| | - Xin Liu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Zi-Lin Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Meng-Nan Yang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Ya-Jie Xu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Hua He
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Fang Fang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Xuan-Xia Mao
- Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China
| | - Xiu-Hua Shen
- Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
| | - Fei Li
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China.
| | - Zhong-Cheng Luo
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China.
- Lunenfeld-Tanenbaum Research Institute, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerity Faculty of Medicine, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5G 1X5, Canada.
| | - Xiaoming Shen
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Huang
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Sun
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiye Wang
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiping Xu
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Li
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yin Huang
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinsong Zhang
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chonghuai Yan
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lisong Shen
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixiao Bao
- Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Tian
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiwei Chen
- International Peace Maternity and Child Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijuan Zhang
- International Peace Maternity and Child Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuanliang Tong
- International Peace Maternity and Child Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Xu
- International Peace Maternity and Child Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhang
- International Peace Maternity and Child Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwen Zhang
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Jiang
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaodan Yu
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangjun Yu
- Shanghai Children's Hospital, Shanghai, China
| | - Jinjin Chen
- Shanghai Children's Hospital, Shanghai, China
| | - Yu Zhang
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaotian Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Haidong Cheng
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Qinying Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Tao Duan
- Shanghai First Maternity and Infant Care Hospital, Tong Ji University, Shanghai, China
| | - Jing Hua
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Hua Peng
- Maternal and Child Health Institute of Yangpu District, Shanghai, China
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Weight gain speed and z-score behavior in large prematures for gestational age. NUTR HOSP 2022; 39:1220-1227. [DOI: 10.20960/nh.04124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Goldberg DL, Becker PJ. Applying the recommended indicators for the diagnosis of preterm and neonatal malnutrition: Answers to frequently asked questions. Nutr Clin Pract 2021; 37:50-58. [PMID: 34967988 DOI: 10.1002/ncp.10814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
In 2018, a committee of expert preterm/neonatal registered dietitian nutritionists published recommended indicators for the diagnosis of malnutrition in preterm infants and neonates. This was in response to a need for indicators appropriate to the preterm/neonatal population, given the emphasis on diagnosing malnutrition in the pediatric and adult population. Since the publication, the authors have received numerous questions regarding the application and use of the indicators. This paper answers questions regarding the three categories of indicators and billing and reimbursement. The goal is to develop uniformity in the application of the malnutrition indicators for quality improvement and research efforts.
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Van Minde MRC, Lagendijk J, Raat H, Steegers EAP, de Kroon MLA. An innovative postnatal risk assessment and corresponding care pathways in Preventive Child Healthcare. J Adv Nurs 2021; 78:739-749. [PMID: 34590735 PMCID: PMC9293120 DOI: 10.1111/jan.15003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/12/2021] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Aims This study aims to evaluate the effectiveness of an innovative postnatal risk assessment (the postnatal Rotterdam Reproductive Risk Reduction checklist: R4U) and corresponding care pathways in Preventive Child Healthcare (PCHC), along with PCHC professional satisfaction. Design Four PCHC organizations located in three municipalities with a higher adverse perinatal outcome than the national average were selected for participation. The study concerns a historically controlled study design. Methods The study enrolled participants from September 2016 until December 2017. The historical cohort existed of children born in previous years from 2008 until 2016. The outcome measure was defined as catch‐up growth: more than 0.67 standard deviation score weight for height increase in the first 6 months of life. PCHC professional opinion was assessed with a digital survey. Results After the inclusion period, 1,953 children were included in the intervention cohort and 7,436 children in the historical cohort. Catch‐up growth was significantly less common in the intervention cohort; 14.9% versus 19.5% in the historical cohort (p < 0.001). A regression sensitivity analysis, using matching, showed an odds ratio of 0.957 (95% CI 0.938–0.976) for the intervention cohort. In the survey, 74 PCHC physicians and nurses participated; most of them were neutral concerning the benefits of the postnatal R4U. Conclusion This study shows that the implementation of a novel postnatal risk assessment including in PCHC is feasible and effective. Final efforts to ensure a widespread implementation should be taken. Impact PCHC offers a unique opportunity to recognize and address risk factors for growth and development in children and to implement care pathways. Effective and widely implemented risk assessments in antenatal and PCHC are scarce. To our knowledge, this kind of evidence‐based postnatal risk assessment has not been implemented in PCHC before and seizes the opportunity to prevent catch‐up growth and its long‐term effects.
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Affiliation(s)
- Minke R C Van Minde
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jacqueline Lagendijk
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marlou L A de Kroon
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Health Sciences, University Medical Center, Groningen, The Netherlands
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Dunn RK, Uhing M, Goday PS. Catch-down growth in infants born large for gestational age. Nutr Clin Pract 2021; 36:1215-1219. [PMID: 34245486 DOI: 10.1002/ncp.10727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Infants born large for gestational age (LGA) not exhibiting catch-down growth (a decline of weight z-score by 1) have a higher likelihood of future obesity. We aimed to identify the term LGA infants in our neonatal intensive care unit (NICU) and document nutrition interventions that may influence growth. Our 10-year retrospective review identified 47 term LGA infants who had a NICU length of stay (LOS) ≥7 days. We obtained demographic data, nutrition interventions in the NICU, and data regarding growth patterns. Of the 47 infants, 31 (66%), demonstrated catch-down growth at discharge at ≥7 days. Overall, 39 of 47 patients (83%) received interventions during their NICU stay, including 32 (69%) who had nasogastric tubes placed, and 24 (51%) had formula fortification to augment weight gain. Among patients with LOS ≥14 days, 23 of 23 patients without catch-down growth and four of five patients with catch-down growth had nutrition interventions performed. Of the overall population, only 38% of those who did not demonstrate catch-down growth had an LOS of ≥14 days vs 77% of all infants that did exhibit catch-down growth (P = .01). Our data suggest that nutrition interventions in LGA infants are common in the NICU. Our study highlights the need for further clinical studies to help direct care in this population of infants.
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Affiliation(s)
- Rachel K Dunn
- Division of Pediatric Gastroenterology, Peyton Manning Children's Hospital, Indianapolis, Indiana, USA
| | - Michael Uhing
- Division of Neonatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Praveen S Goday
- Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Hong YH, Lee JE. Large for Gestational Age and Obesity-Related Comorbidities. J Obes Metab Syndr 2021; 30:124-131. [PMID: 34053939 PMCID: PMC8277589 DOI: 10.7570/jomes20130] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/29/2021] [Accepted: 04/03/2021] [Indexed: 01/11/2023] Open
Abstract
Both small for gestational age and large for gestational age (LGA) size at birth are associated with metabolic complications throughout life. The long-term consequences of LGA have been investigated in only a few studies. LGA is thought to be associated with early obesity and metabolic risk. Understanding how LGA can influence later obesity risk is important for pediatric obesity interventions. Pregnant women who are overweight or obese are at high risk of having LGA babies. Infants born LGA are at increased risk of becoming overweight or obese children, adolescents, and young adults and can have an increased risk of metabolic syndrome later in life and giving birth to LGA offspring. Education and intervention for weight control before and during pregnancy should be conducted to prevent LGA births. Particular attention is needed for women of childbearing age who are diabetic and obese, which could be the starting point for lifelong management of obesity.
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Affiliation(s)
- Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ji-Eun Lee
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
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Liu Q, Yin A, Wen S, Shi X, Fang L, Rao T, Liang J, Wu J. Analysis of amino acids and acylcarnitines profiles in small, appropriate, and large for gestational age neonates. J Matern Fetal Neonatal Med 2020; 35:439-446. [PMID: 32037923 DOI: 10.1080/14767058.2020.1720640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: To identify the amino acid (AA) and acylcarnitines (ACs) profiles in dry blood spot (DBS) of small, appropriate and large for gestational age neonates, and to investigate the difference AA and AC profiles in groups.Methods: Eight thousand nine hundred and fourteen healthy singleton newborns were divided into three groups: small for gestational age (SGA) (n = 713), appropriate for gestational age (AGA) (n = 7866), and LGA (n = 335). Electrospray ionization tandem mass spectrometry was taken to evaluate the concentrations of 11 AAs and 31 ACs in DBS specimens obtained from all enrolled neonates.Results: Compared with the AGA neonates, except propionylcarnitine, the concentrations of SGA neonatal most AAs and AC in the newborn were higher, while those of the newborns in the LGA group were lower.Conclusion: Different concentrations of AAs and ACs in the three groups suggest that SGA may be associated with under anabolic metabolism, while LGA may be associated with over anabolic metabolism.
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Affiliation(s)
- Qian Liu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Aihua Yin
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shen Wen
- Department of Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiaomei Shi
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Liyuan Fang
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Tengzi Rao
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jinqun Liang
- Department of Children Inherited Metabolism and Endocrine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jing Wu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
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Feeding the Late and Moderately Preterm Infant: A Position Paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2019; 69:259-270. [PMID: 31095091 DOI: 10.1097/mpg.0000000000002397] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Nutritional guidelines and requirements for late or moderately preterm (LMPT) infants are notably absent, although they represent the largest population of preterm infants. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a review of the literature with the aim to provide guidance on how to feed infants born LMPT, and identify gaps in the literature and research priorities.Only limited data from controlled trials are available. Late preterm infants have unique, often unrecognized, vulnerabilities that predispose them to high rates of nutritionally related morbidity and hospital readmissions. They frequently have feeding difficulties that delay hospital discharge, and poorer rates of breastfeeding initiation and duration compared with term infants. This review also identified that moderately preterm infants frequently exhibit postnatal growth restriction.The ESPGHAN CoN strongly endorses breast milk as the preferred method of feeding LMPT infants and also emphasizes that mothers of LMPT infants should receive qualified, extended lactation support, and frequent follow-up. Individualized feeding plans should be promoted. Hospital discharge should be delayed until LMPT infants have a safe discharge plan that takes into account local situation and resources.In the LMPT population, the need for active nutritional support increases with lower gestational ages. There may be a role for enhanced nutritional support including the use of human milk fortifier, enriched formula, parenteral nutrition, and/or additional supplements, depending on factors, such as gestational age, birth weight, and significant comorbidities. Further research is needed to assess the benefits (improved nutrient intakes) versus risks (interruption of breast-feeding) of providing nutrient-enrichment to the LMPT infant.
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Fadiloglu E, Tanacan A, Unal C, Aydin Hakli D, Beksac MS. Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies. J Perinat Med 2019; 47:534-538. [PMID: 30817306 DOI: 10.1515/jpm-2018-0373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/24/2019] [Indexed: 11/15/2022]
Abstract
Objective To demonstrate clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies. Methods We retrospectively evaluated 75-g GTT screening results of 356 pregnancies without prompt diagnosis of gestational diabetes mellitus (GDM) between January 2013 and December 2017. Newborns with a birthweight greater than the 90th percentile were evaluated as LGA. Pregnancies with LGA and non-LGA fetuses were compared by demographic and historical factors - maternal age, gravidity, parity, birthweight, birthweek, GTT results and birthweight percentiles - via Student's t-test. Multiple linear regression using the backward elimination method was performed to define the correlation between parameters and LGA (P-value of <0.20 was identified as the threshold). Receiver operator characteristics (ROC) curve analysis was performed for further analysis. Results The cohort was consisted of 45 (12.6%) and 311 (87.4%) pregnancies with LGA and non-LGA fetuses, respectively. Maternal age and 2nd-h GTT results were found to be significantly higher in patients with LGA newborns (P<0.001 and P=0.016, respectively). Fasting glucose levels and GTT 1st-h results were also higher (P=0.112, P=0.065). The coefficient of multiple determination (R2) was 0.055 by multiple linear regression analysis. Accordingly, GTT 2nd-h result and maternal age were statistically significant and contributed to the explanation of LGA, although the R2 value was not that much higher (P=0.016; P=0.001). Maternal age and GTT 2nd-h results were found to be associated with LGA fetuses with area under the curve (AUC) values of 0.662 and 0.608 according to ROC curve analysis. Conclusion Maternal age and 75-g GTT 2nd-h results were significantly higher in gestations with LGA newborns without GDM.
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Affiliation(s)
- Erdem Fadiloglu
- Hacettepe University, Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey, Tel.: +90 5464750175
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Canan Unal
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
| | | | - Mehmet Sinan Beksac
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara, Turkey
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Pre-pregnancy BMI, gestational weight gain and birth outcomes in Lebanon and Qatar: Results of the MINA cohort. PLoS One 2019; 14:e0219248. [PMID: 31265481 PMCID: PMC6605672 DOI: 10.1371/journal.pone.0219248] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/20/2019] [Indexed: 11/19/2022] Open
Abstract
Accumulating evidence has highlighted the role of maternal nutritional status on fetal development, birth outcomes and child health. The Mother and Infant Nutritional Assessment (MINA) cohort is a 3-year follow-up study of pregnant women and their children in Qatar and Lebanon. This study reports on the characteristics and determinants of pre-pregnancy BMI and Gestational Weight Gain (GWG) of MINA particiants, as well as birth outcomes. A total of 272 pregnant women were recruited during their first trimester from primary healthcare centers as well as private clinics in Beirut (n = 194) and Doha (n = 147). During the first visit, data collection included pre-pregnancy weight, sociodemographic and lifestyle characteristics. The weight before delivery and neonatal outcomes were extracted from the medical records. GWG was calculated as the difference between weight before delivery and pre-pregnancy weight and was classified into insufficient, adequate, and excessive, as per the IOM criteria. Overall, 42.1% of women had a pre-pregnancy BMI≥25 Kg/m2 (58% in Qatar vs 30.8% in Lebanon, p<0.001). Only 30.2% of women had adequate GWG, while 25.7% and 44.1% of women had insufficient and excessive GWG, respectively. In the cohort 68.7% of infants had a weight adequate-for-gestational age (AGA), 6.7% were SGA and 24.6% were LGA. The proportions of LGA were higher with greater GWG (p<0.05). After adjustment, Qatari women were 3 times more likely to be overweight or obese before pregnancy while a higher education level was associated with significantly lower odds of pre-pregnancy BMI≥25 Kg/m2. Pre-pregnancy BMI≥25 Kg/m2 and regular breakfast consumption were predictors of excessive GWG (OR: 3.20, CI: 1.48–6.91; OR: 2.84, CI: 1.15–7.02, respectively). The high prevalence of pre-pregnancy overweight and excessive GWG among MINA participants underscores the need for culture-specific intervention programs to promote healthy body weight in women of childbearing age, and prevent excessive weight gain during pregnancy.
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Larson-Nath C, Mavis A, Duesing L, Van Hoorn M, Walia C, Karls C, Goday PS. Defining Pediatric Failure to Thrive in the Developed World: Validation of a Semi-Objective Diagnosis Tool. Clin Pediatr (Phila) 2019; 58:446-452. [PMID: 30596256 DOI: 10.1177/0009922818821891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is no concordance between current diagnostic criteria for failure to thrive (FTT). We analyzed validity of the Semi-Objective Failure to Thrive (SOFTT) diagnosis tool, which uses a combination of subjective and objective components to make the diagnosis of FTT. The tool was used to diagnose FTT in 94 patients who met 1 of 7 accepted criteria for FTT. Concurrent and predictive validity were demonstrated using anthropometric z-scores and change in anthropometric z-scores, respectively. SOFTT results correlated with differences in anthropometric z-scores for length ( P = .011), weight, weight-for-length, body mass index, mid-upper arm circumference, and triceps skinfold thickness ( P < .0001) between those diagnosed as normal and those with FTT. At follow-up, children with FTT compared with children rated as normal had significantly higher change in weight ( P ≤ .001) and body mass index ( P = .026) z-scores. The SOFTT tool leads to the accurate diagnosis of FTT demonstrated by concurrent and predictive validity.
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Affiliation(s)
| | - Alisha Mavis
- 1 Medical College of Wisconsin, Wauwatosa, WI, USA
| | - Lori Duesing
- 1 Medical College of Wisconsin, Wauwatosa, WI, USA
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13
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Di Giovanni I, Marcovecchio ML, Chiavaroli V, de Giorgis T, Chiarelli F, Mohn A. Being born large for gestational age is associated with earlier pubertal take-off and longer growth duration: a longitudinal study. Acta Paediatr 2017; 106:61-66. [PMID: 27743496 DOI: 10.1111/apa.13633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/19/2016] [Accepted: 10/12/2016] [Indexed: 11/27/2022]
Abstract
AIM Perinatal factors seem to influence the onset of puberty, but there is limited information on the potential effect of large size at birth on pubertal growth. This study evaluated pubertal growth in children born large for gestational age (LGA) compared to children born appropriate for gestational age (AGA). METHODS Longitudinal growth data collected from 70 children - 40 AGA and 30 LGA - were analysed. The ages at take-off, peak height velocity, final height and pubertal growth spurts were calculated using the Preece-Baines model I. RESULTS Large for gestational age children showed an earlier age at take-off compared to AGA children (10.1 ± 1.2 versus 11.0 ± 1.4 years, p = 0.007), whereas the age at peak height velocity and at final height was similar. LGA children showed a longer growth spurt duration (2.5 ± 1 versus 1.5 ± 1.2 years, p < 0.001) and total pubertal duration (5.3 ± 1.2 versus 4.6 ± 1.2 years, p = 0.036) than AGA children. Results were similar when stratified by sex. CONCLUSION Being born LGA was associated with an earlier pubertal take-off and longer growth duration. These unique findings, due to the lack of studies on pubertal growth patterns in LGA children, might lead the way to novel research and a different approach to LGA children at the onset of pubertal growth.
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Affiliation(s)
| | - M. Loredana Marcovecchio
- Department of Pediatrics; University ‘G. D'Annunzio’; Chieti Italy
- Aging and Translational Medicine Research Center; CeSI-MeT; Chieti Italy
| | | | | | - Francesco Chiarelli
- Department of Pediatrics; University ‘G. D'Annunzio’; Chieti Italy
- Aging and Translational Medicine Research Center; CeSI-MeT; Chieti Italy
| | - Angelika Mohn
- Department of Pediatrics; University ‘G. D'Annunzio’; Chieti Italy
- Aging and Translational Medicine Research Center; CeSI-MeT; Chieti Italy
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14
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González-Domínguez MI, Lazo-de-la-Vega-Monroy ML, Zaina S, Sabanero M, Daza-Benítez L, Malacara JM, Barbosa-Sabanero G. Association of cord blood des-acyl ghrelin with birth weight, and placental GHS-R1 receptor expression in SGA, AGA, and LGA newborns. Endocrine 2016; 53:182-91. [PMID: 26754660 DOI: 10.1007/s12020-015-0833-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 12/14/2015] [Indexed: 11/29/2022]
Abstract
Although ghrelin in cord blood has been associated to birth weight, its role in fetal and postnatal growth has not been elucidated. The aim of this study was to analyze total ghrelin, acyl ghrelin (AG), and des-acyl ghrelin (DAG) in cord blood of newborns with idiopathic birth weight alterations, and to evaluate protein expression of placental GHS-R1, in order to investigate their correlation with birth weight and placental weight. We performed a cross-sectional comparative study in umbilical cord blood and placentas from healthy mothers of SGA, AGA, and LGA (small, adequate and large for gestational age) term newborns (n = 20 per group). Cord blood total ghrelin, AG, and DAG were measured by ELISA, and placental GHS-R1 expression was evaluated by Western blot. Cord blood DAG was higher in SGA compared to AGA newborns (902.1 ± 109.1 and 597.4 ± 58.2 pg/ml, respectively, p = 0.01) while LGA and AGA showed similar values (627.2 ± 76.4 pg/ml for LGA, p = 0.80). DAG negatively correlated with birthweight (r = -0.31, p = 0.02) and placental weight (r = -0.33, p = 0.02). No differences in AG or total ghrelin were found. GHS-R1 protein in placenta was not differentially expressed among SGA, AGA, and LGA. Our results suggest a role of DAG in intrauterine growth. Further studies are needed in order to elucidate the mechanisms by which DAG participates in fetal growth.
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Affiliation(s)
- Martha I González-Domínguez
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Maria-Luisa Lazo-de-la-Vega-Monroy
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Silvio Zaina
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Myrna Sabanero
- Biology Department, Natural and Exact Sciences Division, University of Guanajuato, Guanajuato Campus, Guanajuato, Mexico
| | | | - Juan Manuel Malacara
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico
| | - Gloria Barbosa-Sabanero
- Medical Sciences Department, Health Sciences Division, University of Guanajuato, Leon Campus. 20 de Enero No. 929 Col. Obregon, 37320, Leon, Guanajuato, Mexico.
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15
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Chiavaroli V, Derraik JGB, Hofman PL, Cutfield WS. Born Large for Gestational Age: Bigger Is Not Always Better. J Pediatr 2016; 170:307-11. [PMID: 26707580 DOI: 10.1016/j.jpeds.2015.11.043] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/27/2015] [Accepted: 11/13/2015] [Indexed: 12/22/2022]
Affiliation(s)
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.
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16
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Olson G, Weiner SJ, Rouse DJ, Reddy UM, Mercer BM, Varner MW, Leveno KJ, Iams JD, Wapner RJ, Ramin SM, Malone FD, Carpenter MW, O’Sullivan MJ, Dinsmoor MJ, Hankins GDV, Caritis SN. Relation between birth weight and weight and height at the age of 2 in children born preterm. Am J Perinatol 2015; 32:591-8. [PMID: 25730133 PMCID: PMC4485423 DOI: 10.1055/s-0035-1544947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate associations between fetal growth and weight at 2 years in infants born preterm using a customized approach for birth weight. STUDY DESIGN This is a secondary analysis of a multicenter trial that included a 2-year follow-up of children born prematurely. Customized birth weight percentiles were calculated using the Gardosi model for a U.S. population, and the relation between customized percentile and weight and height at 2 years (adjusted for gender using z-score) was determined using regression analysis and by comparing z-scores for children with birth weight <10th versus ≥10th percentile. RESULTS Weight z-score at 2 years was significantly lower in the <10th than in the ≥10th percentile group (median [interquartile range, IQR]: -0.66 [-1.58, -0.01] vs. -0.23 [-1.05, 0.55]; p < 0.001), and remained after adjusting for maternal education (p < 0.001). A similar relationship was noted for height z-score between groups (median [IQR]: -0.56 [-1.29, 0.19] vs. -0.24 [-0.99, 0.37]; p < 0.001). Positive relationships between customized birth weight percentile and weight and height at 2 years were noted (p < 0.001 for both), but were not strong (R (2) = 0.04 and 0.02, respectively). CONCLUSION Customized birth weight percentile is a minor determinant of weight at 2 years among children born preterm.
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Affiliation(s)
- Gayle Olson
- Departments of Obstetrics and Gynecology of the University of Texas Medical Branch Galveston, Galveston, TX
| | - Steven J. Weiner
- George Washington University Biostatistics Center, Washington, DC
| | | | - Uma M. Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, M.D
| | - Brian M. Mercer
- Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH and University of Tennessee, Memphis, TN
| | | | | | | | - Ronald J. Wapner
- Thomas Jefferson University and Drexel University, Philadelphia, PA
| | - Susan M. Ramin
- University of Texas Health Science Center at Houston, Houston, TX
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Wentz AE, Messer LC, Nguyen T, Boone-Heinonen J. Small and large size for gestational age and neighborhood deprivation measured within increasing proximity to homes. Health Place 2014; 30:98-106. [PMID: 25240489 DOI: 10.1016/j.healthplace.2014.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 08/04/2014] [Accepted: 08/21/2014] [Indexed: 11/28/2022]
Abstract
Neighborhood deprivation is consistently associated with greater risk of low birthweight. However, large birth size is increasingly relevant but overlooked in neighborhood health research, and proximity within which neighborhood deprivation may affect birth outcomes is unknown. We estimated race/ethnic-specific effects of neighborhood deprivation index (NDI) within 1, 3, 5, and 8km buffers around Oregon Pregnancy Risk Assessment Monitoring System (n=3716; 2004-2007) respondents׳ homes on small and large for gestational age (SGA, LGA). NDI was positively associated with LGA and SGA in most race/ethnic groups. The results varied little across the four buffer sizes.
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Affiliation(s)
- Anna E Wentz
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code CB 669, Portland, OR 97239-3098, USA; Population Studies Center, University of Michigan Institute for Social Research, 426 Thompson Street, Ann Arbor, MI, 48104, USA.
| | - Lynne C Messer
- Portland State University, Community Health - Urban & Public Affairs (SCH), PO Box 751, Portland, OR 97207, USA.
| | - Thuan Nguyen
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code CB 669, Portland, OR 97239-3098, USA.
| | - Janne Boone-Heinonen
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code CB 669, Portland, OR 97239-3098, USA.
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